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Departmental Centers Initiatives

ACUTE CRISIS CENTERS AT FAIRVIEW AND SONOMA

IN JANUARY 2015, acute crisis centers were established on the campus of Sonoma Developmental Center (SDC) and reconfigured at Fairview Developmental Center (FDC) to provide short-term crisis stabilization for up to five individuals with developmental disabilities in a home environment separate from the other developmental center (DC) units. Admission is based on specified criteria due to an acute crisis with the overarching goal of providing person-centered treatment that will expedite the person's return either to their prior residence, or a more suitable community-based residential setting, ideally within 90 days but no longer than one year from the date of admission. To qualify for admission to the acute crisis centers, individuals must meet the following requirements:

Qualify under state and federal requirements for admission to a DC;

Pose an imminent risk for substantial harm to self or others;

Require services and supports that cannot be met in the community;

Have serious or potentially life threatening conditions which require a more restrictive environment for crisis stabilization; and

Determined to be safe to serve in the acute crisis center.

Prior to admission, each individual identified by the regional center as needing crisis services undergoes a comprehensive assessment to determine the need and qualification for crisis admission. Once determined to meet the acute crisis criteria and approved for admission, an interdisciplinary team (IDT) will use the assessment as the basis for formulating an Individual Program Plan (IPP). The acute crisis center offers a comprehensive system of treatment, training, education, recreation, and community involvement developed by the IDT which will include the individual. The IPP reflects objectives necessary to meet the individual's needs and will include the identification and development of services and supports needed for crisis stabilization and successful transition back into the community. The IDT includes, but is not limited to, the person, members of the person's family, individual program coordinator, residence manager/designee, clients' rights advocate, and appropriate professionals. Depending on the individual's needs, disciplines involved may include a rehabilitation therapist, psychologist, social worker, registered nurse, teacher, and direct support professional staff.

The discharge planning process begins at admission. Once the person has stabilized and is no longer in crisis, the IDT will work with the regional center to return the individual to community living.

DC Task Force--Following is a summary of stakeholder comments/recommendations provided through the DC Task Force Implementation Workgroups conducted in 2014 and activities underway by the Department's Developmental Centers Division in regards to the Acute Crisis Centers at SDC and FDC:

Housing design should consider a safe, accessible, open floor plan that is home-like and provides individual bedrooms, while providing considerations for sensory needs, exercise options, and learning

Centers are designed according to state and federal requirements, with private bedrooms for up to five residents. Both centers have passed the required Fire and Life Safety Inspections, were recently licensed by the California Department of Public Health, and have the capabilities to implement exercise options, sensory and other needs as dictated in the IPP process. Centers have large living and dining areas for community interactions.

Consider a capacity of no more than four individuals

Up to five residents will be accepted to each center as allowed for in statute.

There should be clear admission guidelines regarding eligibility, priority of admission, quick timeframes, and highly skilled assessments performed by a specialized team

Admission guidelines are defined in the Lanterman Act and will be followed along with established procedures for a swift review and admission if determined they can be safely served. An admission review team will use the assessment required in Welfare and Institutions Code, Section 4418.7, as well as other assessment tools.

Length of stay should be based on individual need and progress, not to exceed one year. Discharge planning should start upon admission to ensure a safe transition back to the community once stabilized

The length of stay is dictated based on the time needed to stabilize the individual, is not to exceed one year, and discharge planning begins during the admission process.

Enhanced staffing of well trained, highly qualified staff and a system that allows for an increase or decrease in staffing, based on individual needs

Only the most qualified staff are hired and given additional training in crisis management. Staffing ratios are based on the need/acuity of those served.

Utilize a whole team approach to include a multidisciplinary team with an emphasis on transition and enhanced communication throughout the process to include prior and future providers as well as DC staff

The Department has an IPP whole team process which includes a multidisciplinary team. Upon admission, stabilization and transition discussion will occur and communication will be done with providers during the transition meetings.

Provide evidence-based treatment services while measuring the success of individuals through data collection

Data is collected on medication, behavior plans, general event reports and many other areas to identify what is needed to stabilize and transition the individual back to the community.

For further information contact your local regional center or the Regional Resource Development Project (RRDP) that serves your area.